Spinal-pelvic orientation: potential effect on the diagnosis of spondyloarthritis

Alegria, G.C.; Deloire, L.; Herbette, M.; Garrigues, F.; Gossec, L.; Simon, A.; Feydy, A.; Reijnierse, M.; Heijde, D. van der; Loeuille, D.; Claudepierre, P.; Marhadour, T.; Saraux, A.

doi:doi:10.1093/rheumatology/kez240

Objective. To assess associations of spinal-pelvic orientation with clinical and imaging-study findings suggesting axial SpA (axSpA) in patients with recent-onset inflammatory back pain.Methods. Spinal-pelvic orientation was assessed in DESIR cohort patients with recent-onset inflammatory back pain and suspected axSpA, by using lateral lumbar-spine radiographs to categorize sacral horizontal angle (<40 degrees vs >= 40 degrees), lumbosacral angle (<15 degrees vs >= 15 degrees) and lumbar lordosis (LL, <50 degrees vs >= 50 degrees). Associations between these angle groups and variables collected at baseline and 2 years later were assessed using the chi(2) test (or Fisher's exact) and the Mann-Whitney test. With Bonferroni's correction, P < 0.001 indicated significant differences.Results. Of 362 patients, 358, 356 and 357 had available sacral horizontal angle, lumbosacral angle and LL values, respectively; means were 39.3 degrees, 14.6 degrees and 53.0 degrees, respectively. The...Show moreObjective. To assess associations of spinal-pelvic orientation with clinical and imaging-study findings suggesting axial SpA (axSpA) in patients with recent-onset inflammatory back pain.Methods. Spinal-pelvic orientation was assessed in DESIR cohort patients with recent-onset inflammatory back pain and suspected axSpA, by using lateral lumbar-spine radiographs to categorize sacral horizontal angle (<40 degrees vs >= 40 degrees), lumbosacral angle (<15 degrees vs >= 15 degrees) and lumbar lordosis (LL, <50 degrees vs >= 50 degrees). Associations between these angle groups and variables collected at baseline and 2 years later were assessed using the chi(2) test (or Fisher's exact) and the Mann-Whitney test. With Bonferroni's correction, P < 0.001 indicated significant differences.Results. Of 362 patients, 358, 356 and 357 had available sacral horizontal angle, lumbosacral angle and LL values, respectively; means were 39.3 degrees, 14.6 degrees and 53.0 degrees, respectively. The prevalence of sacroiliitis on both radiographs and MRI was higher in the LL < 50 degrees group than in the LL >= 50 degrees group, but the difference was not statistically significant. Clinical presentation and confidence in a diagnosis of axSpA did not differ across angle groups. No significant differences were identified for degenerative changes according to sacral horizontal angle, lumbosacral angle or LL.Conclusion. Spinal-pelvic balance was not statistically associated with the clinical or imaging-study findings suggesting axSpA in patients with recent-onset inflammatory back pain.Show less

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Spinal-pelvic orientation: potential effect on the diagnosis of spondyloarthritis